Constantine Stephen Djedjos, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

026107 Issued in LA

Practice address

1919 East Thomas Rd Main Building, 2ND Floor
Phoenix Childrens Hospital
Phoenix, AZ 85016

Phone

(602) 933-0935

NPI assigned

Aug 21, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1235245507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 EAST THOMAS RD MAIN BUILDING, 2ND FLOOR",
            "address_2": "PHOENIX CHILDRENS HOSPITAL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85016",
            "telephone_number": "602-933-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 EAST THOMAS RD MAIN BUILDING, 2ND FLOOR",
            "address_2": "PHOENIX CHILDRENS HOSPITAL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85016",
            "telephone_number": "602-933-0935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJEDJOS",
        "first_name": "CONSTANTINE",
        "middle_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "026107",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "026107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Ezra Dixon, MD
• Jonathan Dizon
• Lee-Ann C Dizon, APRN, FNP-C
• Frank Dizonno, DPT
• Edwige Dea Djassa, FNP
• Cynthia Djengue, LCSW
• Djio Holdings Incorporated Dba Firstlight Home Care of Cave Creek, Az
• DJLW Health Services Inc.
• Vanja Djurdjevic
• DK Advocates Inc.

• Pediatrics Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.